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Well Being

Where do you start in the search to define happiness? Why would you even try? How arrogant must you be to think you could make a determination as to what constitutes the basis on which another person would be happy?

The World Health Organisation has been exploring ideas about social and economic progress being measured in terms of nations “happiness” levels for some time – see the report of the Commission on the Measurement of Economic Performance and Social Progress which proposed that states should shift from measuring economic production to measuring the well being of citizens as the key measure of how sustainable their economic and social policies were. Recommendation 2 in the report is that social policy should emphasise “the household perspective”. The UK benchmarks above average for most well being measures, however performance is below average for mental well being (20th of 27) and child self-reported health (24th of 38).

Reading about the search for a sustainable home for his son Steven from @MarkNeary1 this last month has emphasised just how important that household perspective is. Reading a day in the life of Mr Neary however is more than that, it is also a reminder that happiness and mental well being are found in the small things, the stuff that you often take for granted. That being able to go to the pub and have a pint is definitely in Mark’s best interest and therefore in the best interests of his son Steven.

1st time in months I've been able to escape to the pub for an hour on Saturday afternoon. Sitting here with a pint, doing umpteen lists.

Which takes us to the question, if social care policy and law is about well being and happiness, is social care in the happiness business? See this from digital story teller @JohnPopham who visited an older people’s care home earlier this week.

Improving subjective well being has been a focus for UK social care policy leading up to the Care Act (2014) which introduced the legal duty that Local Authorities are responsible for promoting well being, that people being happy is in their best interest:

The first legal challenge to how well Council’s are meeting this new general duty is due in Court this autumn, following Luke Davey and his mother having won the right to bring a judicial review of changes made by Oxfordshire Council to his support. Luke defines well being in terms of being able to get a drink and go to the toilet without the need of his mum having to assist. What is striking is how far away such ambitions are from the lofty, ambitions of those who believe that they can at scale and pace transform the system of health and social care.

When we forget that it’s the small things define happiness and mental well being, do we start the slide that leads us away from seeing people as being fully human, is it that moment of loosing sight on what constitutes happiness which leads to unhappiness, captured so distressingly in extract from Tony Osgood writing about “serviceland” that strange place where commissioners think they know better than people about what they want and need in their lives:

Service land makes for uncomfortable reading. It leaves commissioners of “care and support” facing a series of uncomfortable questions. Do we sometimes get confused in social care about the limitations of our legal powers? Do we confuse the role of Social Workers as being a form of “soft police”, dressing up interference in people’s lives as being a form of safeguarding of people’s well being. Do we focus on physical aspects of safety to the detriment of mental well being? And in doing so, do we create the conditions which lead to unhappiness, which lead in a self-perpetuating cycle to more “challenging behaviour” which leads to us thinking we need to commission yet more services to meet the very needs we have created? Service land is a place of unhappiness. How typical is it of people’s experience?

“The fact is that all life involves risk, and the young, the elderly and the vulnerable, are exposed to additional risks and to risks they are less well equipped than others to cope with. But just as wise parents resist the temptation to keep their children metaphorically wrapped up in cotton wool, so too we must avoid the temptation always to put the physical health and safety of the elderly and the vulnerable before everything else. Often it will be appropriate to do so, but not always. Physical health and safety can sometimes be bought at too high a price in happiness and emotional welfare. The emphasis must be on sensible risk appraisal, not striving to avoid all risk, whatever the price, but instead seeking a proper balance and being willing to tolerate manageable or acceptable risks as the price appropriately to be paid in order to achieve some other good – in particular to achieve the vital good of the elderly or vulnerable person’s happiness.

What good is it making someone safer if it merely makes them miserable?”

The #7DaysofAction campaign is exposing that unhappiness is the experience of many within the health and social care “system”. 36 families have now come forwards to tell their story. The campaign will be telling these stories in October, and as social care professionals we will be listening. There is a social care commissioner and social worker involved in each and every story, but crucially, will we be able to detect the social work or will we be hearing something else?